What We Do

Recovering and Financing Underpaid Insurance Claims for Healthcare Providers

Healthcare providers routinely navigate tight margins, largely due to insurer underpayments, delays, and denials. To overcome these challenges, providers need to explore innovative healthcare reimbursement strategies.

Allia Group’s pioneering healthcare litigation finance platform enables providers to target underpaid insurance claims up to approximately six years old, depending on state law. Contrary to traditional revenue cycle management (RCM solutions), the expanded time frame provides more opportunities for revenue recovery.

Through a combination of proprietary data analysis and bundling, our multidisciplinary staff evaluates a variety of claim types, the associated insurance plans, and case strategies to effectuate the highest immediate yield and greatest long-term financial impact.

Over the past 14 years, our analysis has indicated that out-of-network claims are underpaid by as much as 80 percent. 

This means providers are only receiving 20 cents for every dollar of service rendered. Not only is underpayment harmful to providers, but it can have significant financial consequences for the healthcare business model and the quality of care to patients.

By leveraging litigation healthcare providers can effectively challenge insurers and transform their healthcare reimbursement and revenue recovery strategies.

The Impact of Healthcare Litigation Finance

Join An Alliance of Providers

Navigating the power struggle against insurance carriers alone can be overwhelming for healthcare providers. In order to create a unified alliance, Allia Group implements a bundled case model to bring providers together.

By aggregating claims across various physician groups and hospitals, Allia enables providers to collectively challenge insurers and push for industry-wide changes in healthcare reimbursement practices. This collaboration helps restore the balance of power between insurers and providers and levels the playing field.

Extend and Complement the Revenue Cycle

Healthcare litigation extends the timeframe for recovering insurance balances by approximately six years, depending on state laws. This strategy complements traditional healthcare revenue cycle management (RCM solutions) by providing an additional method for healthcare revenue optimization.

By integrating litigation strategies with healthcare RCM solutions, providers enhance their ability to secure the full payments owed, leading to improved financial outcomes.

Focused Expertise, Universal Solutions

Though healthcare litigation finance is most often utilized in out of network disputes, Allia Group’s healthcare litigation finance strategy is a powerful tool for in-network healthcare reimbursement strategies as well.

Our litigation finance solution can be tailored towards your healthcare business’s unique structure for maximum impact.

IDR Managed Service

Leverage Allia’s Litigation Expertise with our IDR Managed Service

The No Surprises Act’s federal Independent Dispute Resolution (IDR) Process is designed as an accelerated form of revenue recovery on underpaid claims, but has proven to be overly complex for providers. To solve this, Allia Group has applied experience advocating for fair reimbursements for out of network disputes in a litigation context to the federal IDR process.

Why Use an IDR Managed Service?

Allia’s IDR managed service removes the administrative burden on providers and billers, while also advancing required fees associated with the IDR process. Extensive experience in litigation allows Allia Group to create qualified batches and implement optimal, data-driven bidding strategies. This supplies providers with an accelerated format of healthcare reimbursement for out-of-network claims to compliment their traditional recovery models.

Contact Us for More Information

Allia Group’s specialized expertise helps maximize revenue recovery for healthcare providers through our IDR managed service. As the No Surprises Act continues to evolve, we review new regulations and court decisions, staying informed and providing information to ensure your success. If you have questions or need guidance regarding the IDR process, contact us today for a consultation and see how we can enhance your revenue recovery efforts.

Who Benefits from Healthcare Litigation Finance?

Physician
Groups

Physician
Groups

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Physician Management Firms

Physician Management Firms

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Hospital
Systems

Hospital
Systems

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EMS
Companies

EMS
Companies

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Healthcare Litigation Financing Solutions

Allia Group offers several litigation finance structures to fit providers’ financing needs, whether the provider needs immediate cash flow or prefers to receive payments over time as additional claims are settled and processed. These flexible litigation finance structures empower healthcare revenue optimization and ease financial pressures for healthcare providers.

Immediate Liquidity Structure

Once the underwriting and due diligence process is complete, the provider receives an upfront purchase payment for immediate cash flow.

Incremental Payment Structure

Allia Group purchases claims based on a formula related to recoveries from resolutions of each case.

Hybrid
Structure

This option includes immediate cash flow in an upfront payment of the claims purchase and additional payments related to recoveries of resolutions from each settlement.

Schedule an Initial Consultation

Secure funding and start recovering revenue from underpaid insurance claims for your healthcare practice by filling out the form below. One of our healthcare revenue recovery specialists will respond shortly.

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